<link href="//netdna.bootstrapcdn.com/bootstrap/3.1.0/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css">
<script src="//netdna.bootstrapcdn.com/bootstrap/3.1.0/js/bootstrap.min.js"></script>
<script src="//code.jquery.com/jquery-1.11.1.min.js"></script>
<div class="container">
<form role="form" style="width:400px; margin: 0 auto;">
<h1>Contact us</h1>
<div class="required-field-block">
<input type="text" placeholder="Name" class="form-control">
<div class="required-icon">
<div class="text">*</div>
</div>
</div>
<div class="required-field-block">
<input type="text" placeholder="Email" class="form-control">
<div class="required-icon">
<div class="text">*</div>
</div>
</div>
<input type="text" placeholder="Phone" class="form-control">
<div class="required-field-block">
<textarea rows="3" class="form-control" placeholder="Message"></textarea>
<div class="required-icon">
<div class="text">*</div>
</div>
</div>
<button class="btn btn-primary">Send</button>
</form>
</div>